摘要
目的系统评价静脉注射免疫球蛋白(IVIG)治疗中国重症手足口病患儿的疗效。方法计算机检索CNKI、CBM、Wan Fang Data、Pub Med和The Cochrane Library(2015年第2期)数据库,搜集在常规治疗的基础上给予IVIG治疗(IVIG组)与单纯常规治疗(对照组)比较治疗中国重症手足口病患儿的相关随机对照试验(RCT),检索时限均从建库至2015年3月。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.3和Stata 9.0软件进行Meta分析。结果共纳入23个RCT,包括2 271例患儿。Meta分析结果显示:IVIG组的总有效率明显高于对照组[RR=1.18,95%CI(1.11,1.26),P<0.000 01],患儿的退热时间[MD=-1.47,95%CI(-1.80,-1.15),P<0.000 01]、皮疹消退时间[MD=-1.61,95%CI(-2.51,-0.71),P=0.000 5]、神经症状缓解时间[MD=-2.14,95%CI(–3.02,-1.25),P<0.000 01]、口腔溃疡消退时间[MD=-1.36,95%CI(-2.27,-0.44),P=0.004]和平均住院时间[MD=-2.46,95%CI(-3.29,-1.63),P<0.000 01]均明显短于对照组,且差异均有统计学意义。结论在常规治疗的基础上给予IVIG治疗较单用常规治疗可以提高中国重症手足口病患儿治疗的疗效。但受纳入研究质量的限制,本研究结论尚需开展更多高质量的RCT进行验证。
Object To systematically review the efficacy and safety of intravenous immunoglobulin （IVIG） for children with severe hand, foot and mouth disease in China. Method Databases including CNKI, CBM, WanFang Data, PubMed and The Cochrane Library （Issue 2, 2015） were searched to collect randomized controlled trials （RCTs） about IVIG combined with conventional therapy versus conventional therapy alone for severe hand, foot and mouth disease from inception to March 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 and Stata 9.0 software. Result A total of 23 RCTs involving 2 271 patients were included. The results of meta-analysis showed that, compared with the conventional therapy group, the IVIG group had higher total effective rate （RR=1.18, 95%CI 1.11 to 1.26, P〈0.000 01）, shorter fever relieving time （MD= -1.47, 95%CI -1.80 to -1.15, P〈0.000 01）, shorter rash regression time （MD= -1.61, 95%CI -2.51 to -0.71, P=O.O00 5）, shorter remission time of nervous symptoms （MD= -2.14, 95%CI -3.02 to -1.25, P〈0.000 01）, shorter mouth ulcer regression time （MD= -1.36, 95%CI -2.27 to -0.4, P=0.004）, and shorter average length of hospital stay （MD=-2.46, 95%CI-3.29 to -1.63, P〈0.000 01）. Conclusion Compared with conventional therapy alone, IVIG combined with conventional therapy can improve the effect for severe hand, foot and mouth disease. Due to the limited quality of the include studies, more high quality studies are needed to verify the above conclusion.
出处
《中国循证医学杂志》
CSCD
2016年第1期87-95,共9页
Chinese Journal of Evidence-based Medicine
关键词
免疫球蛋白
重症手足口病
系统评价
Meta分析
随机对照试验
Immunoglobulin
Severe hand, foot and mouth disease
Systematic review
Meta-analysis
Randomized controlled trial
